Nomogram for predicting postoperative ileus after radical cystectomy and urinary diversion: a retrospective single-center study

Ann Med. 2024 Dec;56(1):2329125. doi: 10.1080/07853890.2024.2329125. Epub 2024 Mar 18.

Abstract

Objective: To predict the incidence of postoperative ileus in bladder cancer patients after radical cystectomy.

Methods: We retrospectively analyzed the perioperative data of 452 bladder cancer patients who underwent radical cystectomy with urinary diversion at the Second Hospital of Tianjin Medical University between 2016 and 2021. Univariate and multivariate logistic regression were used to identify the risk factors for postoperative ileus. Finally, a nomogram model was established and verified based on the independent risk factors.

Results: Our study revealed that 96 patients (21.2%) developed postoperative ileus. Using multivariate logistic regression analysis, we found that the independent risk factors for postoperative ileus after radical cystectomy included age > 65.0 years, high or low body mass index, constipation, hypoalbuminemia, and operative time. We established a nomogram prediction model based on these independent risk factors. Validation by calibration curves, concordance index, and decision curve analysis showed a strong correlation between predicted and actual probabilities of occurrence.

Conclusion: Our nomogram prediction model provides surgeons with a simple tool to predict the incidence of postoperative ileus in bladder cancer patients undergoing radical cystectomy.

Keywords: Postoperative ileus; bladder cancer; nomogram; prediction model; radical cystectomy.

MeSH terms

  • Aged
  • Cystectomy / adverse effects
  • Humans
  • Ileus* / epidemiology
  • Ileus* / etiology
  • Ileus* / surgery
  • Nomograms
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Urinary Bladder Neoplasms* / surgery
  • Urinary Diversion* / adverse effects

Grants and funding

This research was supported by The National Key Research and Development Program of China (2021YFC2009300, 2021YFC2009303), the Open Fund of State Key Laboratory of Environmental Chemistry and Ecotoxicology (KF2021-20).